Let's Talk Birthing Choices

So....  the I tried the super medical approach-  you know, the explore-everything-that-could-ever-possibly-go-wrong route.  I went to the Medical University (MU).

1. They mixed up my medical records with another lady who was 5 months further* along than me.  When I told them this fact, they argued with me until I insisted on giving them my social security number.
2. The MU insisted that I have an internal ultrasound at 8 weeks.  When the doctor performed said ultrasound, she placed the transducer in the wrong place.  Only after I told her she was in the wrong neighborhood did she remove the transducer and start searching for the right neighborhood.  No explanation.  No apology.
3. Once my clothes were back on, they told me I needed a pelvic exam.
4. When I spoke with the OBGYN, he gave me the following information:
   a)  Although I am in a fully monogamous marriage and have been for years, I had to have $1000 bloodwork done to test for HIV, syphilis, and Hepatitis B.
   b)  I would need a new and different test every visit to determine any and everything that could be wrong with my baby.
   c)  At 20 weeks I would need another internal ultrasound to take a comprehensive look at each of my baby's organs to make sure they were properly forming and functioning.
   d)  Finally, we discussed my desired for a VBAC.  The doctor very cavalierly said that he would hope for a VBAC if that is what I wanted, but when the time came, I would end up having a Cesarean because that is what would be best for me and the baby since I had a Cesarean under my belt (no pun intended) already.  
5. When I inquired about all the tests, the OBGYN told me that they are very thorough with their patients.  Apparently the MU treats all high risk cases the same.  However, all high risk cases are not the same.  I asked specifically about the test for Down Syndrome.  "I'm not even 30...  am I really at risk?"  To which the OBGYN said that he thought everyone should have the test.  I am a minimally invasive, hands off kind of gal.  Constant, expensive, unnecessary testing sounds scary, uncomfortable, and like something to which neither my baby or I need to be subjected. 

I came home in tears.  I was no longer excited to be pregnant.  Sure, I was still excited to be adding a new child to our family, but I was horrified and terrified at the road ahead of me.  Over dinner I poured out my feelings to Jason and told him that I never wanted to be pregnant again.  Sure I am the pregnant one, but somehow, all of the decision-making was left to other people.  He looked me straight in the eye and said, "Blythe, clearly this is not our best option."  We called the birthing center the very next day to ask if there was any chance they could do my prenatal care again.  Turns out, the answer was yes, but I would need to deliver at the local hospital.  I made an appointment and the midwives three weeks later.  We discussed how I was feeling and how I could listen to my body.  I love that at the birthing center, the biggest (though of course not the only) indicator of my pregnancy health is what my body is telling me.  

When I came home from the birthing center, I was energetic and excited.  I was ready to be pregnant.  I didn't have anxiety from the idea that people were going to poking and prodding me for nine months with no reverence for the fact that I am a person, not merely and incubator.  

Women's birthing options are disappearing.  We are hardly given information on our options as is, but now our options are simply disappearing.  I think my favorite remark I have received after revealing that I prefer birthing centers over hospitals is, "Well, you're taking a huge risk.  You're putting your baby at risk."  To that person I say, if you were more educated about all of a woman's birthing options, you would understand that everything birthing situation comes with its share of risk, and, Honey, it's not your fault for not knowing that.  We, as a society, should be much more proactive about informing pregnant couples (and people just wanting information) about women's birthing options.  There are many.

1. Home Birth: This allows a woman to give birth in the privacy of her home.  Most women who decide on a home birth prefer their own space.  In her own space, smells, lighting, temperatures, etc. are controllable and predictable.  Mammals are designed to birth in environments that are quiet, low lighting, and private.  Did you know that a dog will actually take herself out of labor if her environment isn't quiet and private enough?  This is probably why home births generally lead to more natural, fewer complication births.  However, home birth means at home, and I don't know about you, but I don't have an OR in case of emergencies located in my house.  Home birth carries a risk of not getting to a hospital in time.  Also, currently (I did some research, but would love to be corrected on this), it is not illegal to give birth in your home in ANY state, but it IS illegal in some states to have someone besides an OBGYN do a medical procedure.  For example:  It is legal to push a baby out in your home, but it may be illegal to have a midwife check how dilated you are.
2. Birthing Center:  This is the medium between home birth and the hospital.  It's a medical environment that is designed to be as homey and hands-off as can be unless otherwise necessary.  Often these establishments have hospital affiliates for situations that arise that may need medical attention beyond the scope of a midwife.  Birthing centers focus on natural birth, offering options such as waterbirths, birthing balls, and birth stools for pain management.  Birthing without medication has proven to lower rates of cesarean.  Again, you are not at a hospital, so there is no surgical equipment or pain medication should you decide birth is overwhelming.  At a birthing that is more hands-off, if you want certain tests done (like genetic screening), you will need to speak up.  They will not just casually do it.
3. Hospital:  Medical intervention at its finest.  Hospitals save lives.  They are equipped with the highest level of education doctors and the tools to help get that baby out in any situation.  That have medication, nurseries, OBGYNS, neonatal specialists.  Hospitals tend to take the reins out of the mother's hands, and that makes some women more comfortable when giving birth.  In hospitals, Doctors deliver babies, whereas midwives "catch" the baby you delivered.  Hospitals also have about a 1 in 4 Cesarean Section rate, whether needed or not.
4. Obstetrician:  Delivers at the hospital.  An OB is the most educated person to bring your baby into this world.  However, OBs like to be in charge.  They will make decisions for you.  They will put pressure to do things her/his way.
5. Family Practitioner:  Generally delivers in hospital.  Good for low risk pregnancies.
6. Midwife:  Midwives can have a wide spectrum of training. Certified nurse-midwives have a nursing degree and additional training in midwifery. Direct-entry midwives or certified professional midwives have extensive training in midwifery even though they do not have a nursing degree. Most midwives offer care that is flexible and individualized with little medical intervention. Because of limited formal training, they usually limit their care to low risk pregnancies. Many midwives offer deliveries in homes, birthing centers, or hospitals.**
7. Unassisted:  is just that:  unassisted.  Check out this blog on why this mother chose unassisted child birth.
8. Natural:  No medication.  It works on your body's natural production of Oxytocin rather that the synthetic Pitocin.  No epidural.  Natural birth only uses what mother nature thought was requisite.  
9. Vaginal:  This can be with or without pain medication.  Maybe part one way, part another.  This can be done EVEN IF you have already had a Cesarean.
10. Cesarean:  Surgery to get your baby out performed in an operating room.  Sometimes it is an emergency, sometimes it is planned.  This can limit your number of children.  

And you know what?  I don't care what you choose.  I know that for me, for my family, a birthing center prenatal care and a hospital delivery with midwives catching my baby is best.  If it's not for you, that is perfectly okay.  And do not let anyone make you feel uncomfortable about it.  As a mother and as a couple, that is yours to decide.  

*Okay, Grammar Police, I consulted my personal Grammar Police and was advised that either could be considered correct. We could be saying "farther" because we can measure a pregnancy as having 40 weeks in it, and therefore could be discussing a measurable amount of time.  However, we decided that "further" would be more correct since most pregnancies do not actually measure 40 weeks (either going over or under).  Feel free to leave your opinion.  

**Explanation taken from americanpregnancy.org